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2. Last Name*
3. First Name*
4. Middle Initial
6. Case Number(s)*
8. Address1*
10. Address2
12. City*
13. State*
14. ZIP Code*
16. You may elect to seek a decision on written statement rather than appear for an in-court hearing. The below information must be filled out and, pursuant to IMC-CRLJ 3.5(b), must be received at least five days prior any previously set in-court hearing. The court will review your declaration and the police officer’s sworn statement and render a decision. The infraction will be found committed and a monetary penalty will be determined. The penalty will be based on the facts of the case and your driving record. If you are charged with No Proof of Insurance under RCW 46.30.020, and have proof that you are or were properly insured on the date of violation. Please include a copy of that proof along with your declaration. Pursuant to CRLJ 3.5(c) and IMC-CRLJ 3.5(e) there shall be no appeal from a decision on written statement.
18. Options*

    1. I wish to request a deferred finding. No other statement is necessary. I understand that my request for a deferred finding is final.
    2. I wish to mitigate the infraction(s) and seek a fine reduction. Please complete the statement below as to why you feel the fine should be reduced in this case.
20. Statement
22. Upload Statement/Attachment (Optional)
24. Please select today's date:*
    Please select today's date:
26. I declare under penalty of perjury of the laws of the State of Washington that the above information and the information contained in the attachments hereto, is true and correct. I understand there can be no appeal from a decision on a written statement, pursuant to CRLJ 3.5 (e) and IMC-CRLJ 3.5 (e). I have read the above and understand that by requesting a deferred finding, my request is final. I am unable to change my request once the judge has granted the deferred finding.
28. I have read and agreed to the terms and conditions:*

    1. Yes
30. Electronic Signature*
31. Email Address*
33. I allow the court to notify me of the Judge's decision via email. *

    1. I agree
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35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field